Asphyxial deaths: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Asphyxial deaths

Sample item

A person is found dead after a stampede in a crowd, with a swollen cyanosed face, conjunctival petechiae and congestion above the chest, while the skin below the chest is pale. What is the mechanism of death?

AManual strangulation by pressure on the neckBChoking by obstruction of the airway within the throatCTraumatic asphyxia from chest compression preventing respiratory movementDSmothering by blockage of the nose and mouth

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Traumatic asphyxia from chest compression preventing respiratory movement

In traumatic (compression) asphyxia, severe external pressure on the chest prevents expansion and venous return, so the head, neck and upper chest show intense congestion, cyanosis and petechiae. The area under the compression is typically pale.

Option by option

A. Manual strangulation by pressure on the neck
Manual strangulation leaves marks on the neck and would not explain a pale lower trunk.
B. Choking by obstruction of the airway within the throat
Choking is intraluminal airway obstruction by a foreign body or food, not external compression.
C. Traumatic asphyxia from chest compression preventing respiratory movement (correct)
Correct. Chest compression explains the congestion above the level of pressure with a pale lower trunk.
D. Smothering by blockage of the nose and mouth
Smothering involves external blockage of the nose and mouth and would not produce the sharp demarcation described.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, Traumatic asphyxia from chest compression preventing respiratory movement. In traumatic (compression) asphyxia, severe external pressure on the chest prevents expansion and venous return, so the head, neck and upper chest show intense congestion, cyanosis and petechiae.

Why is "Manual strangulation by pressure on the neck" not the answer?

Manual strangulation leaves marks on the neck and would not explain a pale lower trunk.

Why is "Choking by obstruction of the airway within the throat" not the answer?

Choking is intraluminal airway obstruction by a foreign body or food, not external compression.

Why is "Smothering by blockage of the nose and mouth" not the answer?

Smothering involves external blockage of the nose and mouth and would not produce the sharp demarcation described.

What concept does this question test?

It tests Asphyxial deaths in Forensic Medicine. The area under the compression is typically pale.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Asphyxial deaths?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.